MEDICARE: ASHLEY MANNERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	040.0134021	VT

General Provider Information

NPI Number	:	1942781323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MANNERS

Provider Business Mailing Address
First Line	:	399 HOLBROOK BAY CMNS APT 28
Second Line	:
City	:	NEWPORT CENTER
State	:	VT
Zip	:	05857-9316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	399 HOLBROOK BAY CMNS APT 28
Second Line	:
City	:	NEWPORT CENTER
State	:	VT
Zip	:	05857-9316
Country	:	US
Telephone Number	:	413-834-8412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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Directions to “ ASHLEY MANNERS ” Practice Location

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